Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A Case of Plastic Bronchitis Associated Influenza A Pneumonia Requiring ECMO Assistance

  • An, Hong Yul (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Baek, Seung Min (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Choi, Youn Young (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, You sun (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Lee, Eui Jun (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Choi, Yu Hyeon (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Choi, Yun Jung (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Suh, Dong In (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kwak, Jae Gun (Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine) ;
  • Kim, Woong-Han (Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine) ;
  • Park, June Dong (Department of Pediatrics, Seoul National University College of Medicine)
  • Received : 2017.09.15
  • Accepted : 2017.10.14
  • Published : 2018.08.25
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Abstract

A 6-year-old boy with underlying hemolytic anemia of unknown etiology, atopic dermatitis, and recurrent urticaria visited our hospital because of acute respiratory failure induced by influenza A. Despite mechanical ventilation after endotracheal intubation along with inhalation of nitric oxide, respiratory acidosis and hypoxemia persisted. Veno-venous extracorporeal membrane oxygenation (VV ECMO) insertion was performed to provide respiratory support. After performing flexible bronchoscopy, we found that thick mucus plugs were obstructing the right bronchus intermedius and the upper lobe orifice. After bronchial washing and removal of the plugs, we were able to wean the patient off VV ECMO and transfer him to the general ward. He was discharged without any neurologic or pulmonary sequelae.

6세 남아가 인플루엔자 A 바이러스 감염 이후 급성 호흡부전 상태에서 내원하였다. 기관 삽관 이후 인공 호흡 및 산화 질소공급에도 호흡성 산증 및 저산소증의 호전이 없어 내원 9시간 이후 체외막 산소 공급을 이용하여 호흡 보조를 시행하였다. 내원 12시간 이후 기관지경을 이용하여 우측 중간 기관지부터 상엽 구멍을 막고 있는 단단한 점액 마개를 제거하였다. 이후 환자는 신경계와 호흡기계 후유증 없이 퇴원하였다. 저자들은 플라스틱 기관지염으로 인한 급성 호흡 부전 상태의 환자에서 신속한 체외막 산소 공급 및 기관지경술의 처치를 시행함으로써 후유증 없이 치료한 사례를 보고한다.

Keywords

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